Text in English / With the Acquired Immune Deficiency Syndrome (AIDS), first recognised in 1981 as a new disease that subsequently took on pandemic proportions, home-based caregivers became instrumental to ensure that, notwithstanding the encumbered health care systems, people living with HIV and AIDS (PLWHA) receive care, support and treatment within their households to live prolonged dignified lives. Despite their pivotal role in the field of HIV and AIDS care, there seems to be a dearth of literature, and research locally and internationally, from the ambit of Social Work on the topic of how HBCGs manage and cope with the work-related challenges they experience when caring for PLWHA and their need for Social Work support. Through this exploratory, descriptive, contextual and phenomenological qualitative study, I scrutinised the HBCGs’ experiences and associated challenges and the coping strategies they employ to address these challenges as well as their views on how social workers could support them in overcoming these challenges in the specific case on home-based care to PLWHA. Twenty-five HBCGs were identified and recruited through purposive and snowball sampling techniques from twelve home-based care organisations in South African provinces, namely, North West, Limpopo and Gauteng. Data was collected through individual face-to-face semi-structured interviews using an interview-guide. Data analysis was conducted through Tesch’s eight steps (in Creswell 2014:189) while Guba’s model (in Shenton, 2004) was adopted for data verification. Cast against Loretta Williams’ (2014) middle range theory of caregiving dynamics (Williams 2014), the coping theory of Lazarus and Folkman (1984) and the strength-based perspective (Saleebey, 2013) adopted as theoretical frameworks for this study, the following findings were revealed. The HBCGs were motivated by, among other factors, their mere desire to care for PLWHA; their personal experiences of caring for an ill relative; and future career aspirations to become involved in this care work. HBCGs were found to face various work-related challenges in connection with reactions from community members, the patients and their relatives; their unsafe working conditions; as well as from their colleagues, other role players and their own organisations. It was found that for most of the HBCGs their care work saddened, pained and discouraged them. In the midst of feeling sorry for their patients, they feared getting infected themselves, in addition to their work-related challenges that caused them to experience feelings of failure. The strategies adopted to cope with their work-related challenges included getting support from employers, receiving counselling and becoming involved in support groups. Finally, several suggestions were directed to the management structures of HBC organisations, the HBCGs themselves and social workers on how they could address the work-related challenges. Based on the research findings, some recommendations are forwarded concerning guidelines for Social Work support directed at work practice, policies and programmes; associated education and training endeavours; and continuous professional development initiatives, as well as avenues for further research. / Social Work / D. Phil. (Social Work)

Text in English / INTRODUCTION: Late in HIV epidemic while HIV program is maturing studies in rich and resource limited setting have shown controversial results with regard to whether childbearing desire and intention are changed after the expansion of ART and PMTCT services. There are few studies in Ethiopia which tried to find out fertility preferences after the decentralized ART and PMTCT services. PURPOSE: The objective of the study is to determine the prevalence of fertility desire, intention and associated factors among HIV positive males and females at health facilities in Hawassa city with chronic HIV care. METHOD: The study used quantitative, observational, analytic and cross-sectional study design. It was structured on Trait-Desire-Intention-Behaviour theoretical frame work. A gender based stratification followed by random sampling method was applied. An interviewer-administered structured data collection approach using the pre-tested questionnaire was applied in the study. The Microsoft Office Excel 2007 and Epi-Info version 3.5.3 were utilized for data analysis. In addition to descriptive statistics, both bivariate and multivariable logistic regressions were used to analyse the data. RESULT: With a respondent rate of 93%, a total of 460 PLHIV participated in the study with equal number of males and females. The majority of the participants were from urban (85%), in relationship (70.9%), and on ART (80%). The reported fertility desire, 43.9% (45.2% in males; 42.6% in females), and fertility intention, 44.9% (46.4% in males; 43.4% in females), were high. The median number of intended children was 2. About 54% of PLHIV were using at least one of the contraceptives with 32.4% of unmet need of family planning. Participants with overall experinece of 2 births or less (AOR: 2.4 95% CI 1.32-4.32; p-value=0.0042), without birth experience after HIV diagnosis (AOR:0.52 95% CI 0.28-0.98; p-value=0.0424) and whose partner also desired for childbearing (AOR: 19.73 95%CI 10.81-35.99; p-value=0.0000) were more likely to intend for a/another child.They wished and planned to get birth because; they did not have a/children before or fear of childless stigma (25.3%), ART could help to have negative child (21.8%), importance of parenthood (17.8%) and the desire of once partner (16.8%). The study participants had consulted health care workers (34.2%), approached their partner or their partner had already approached them (27.6%), tried to get a partner or married (17.6%) and stop using family planning (6%) to get pregnant. CONCLUSION: This study highlights high fertility desire and intention in the background of high unmet need for family planning among PLHIV. A development of comprehensive male partner-involved couple counseling protocol, improving the communication HCWs have with PLHIV to emphasize safer conception methods and strengthening all the components of PMCT integrating with other SRH services at chronic HIV clinic are critical. / Health Studies / M.A. (Public Health)

The escalating number of people infected by HIV and AIDS poses a challenge to current resources both at the hospital and household level. Community/Home based care is a viable option in response to the scourge of HIV/AIDS to compliment secondary and tertiary care as well as providing support to affected families in coping with the stress of caring for their terminally ill family members. This study explored the effectiveness of the implementation of Community/Home based care services by focusing on three sites at Bushbuckridge i.e. Cunningmore, Maviljan and Hluvukani. Findings revealed that family members were satisfied to have community caregivers entering their homes to provide care and support to their AIDS ill family members. Significant barriers were highlighted by families and community caregivers that hinder effective implementation of the programme, for instance, cultural sensitivity. The study proffered recommendations on how to deal with these issues. / SOCIAL WORK / MA(SS) (SOCIAL WORK)

With an estimated 500 infections everyday, the country is beset with a galloping HIV and AIDS epidemic. With these accelerating numbers, it is no longer possible to ignore people living with HIV and AIDS, as they will inevitably form a more and more significant volume of the workforce. A key aspect of this phenomenon, that needs dedicated attention, is the issue of their stigmatisation in the workplace. The intent is to present the voice of the stigmatised. The dissertation attempts to understand how a stigmatised identity affects a productive member of society. It tries to capture the perspective of sero-positive persons as productive members of society and not as `victims' or `threats'. The ultimate objective is to influence policy in the workplace in order to provide a nurturing and productive work environment. The key thought emerging from the research is: driven by the inescapable structural stigma of the workplace, the virus fundamentally influences the self-definition of the sero-positive person. / Sociology / M.A.

With an estimated 500 infections everyday, the country is beset with a galloping HIV and AIDS epidemic. With these accelerating numbers, it is no longer possible to ignore people living with HIV and AIDS, as they will inevitably form a more and more significant volume of the workforce. A key aspect of this phenomenon, that needs dedicated attention, is the issue of their stigmatisation in the workplace. The intent is to present the voice of the stigmatised. The dissertation attempts to understand how a stigmatised identity affects a productive member of society. It tries to capture the perspective of sero-positive persons as productive members of society and not as `victims' or `threats'. The ultimate objective is to influence policy in the workplace in order to provide a nurturing and productive work environment. The key thought emerging from the research is: driven by the inescapable structural stigma of the workplace, the virus fundamentally influences the self-definition of the sero-positive person. / Sociology / M.A.

The escalating number of people infected by HIV and AIDS poses a challenge to current resources both at the hospital and household level. Community/Home based care is a viable option in response to the scourge of HIV/AIDS to compliment secondary and tertiary care as well as providing support to affected families in coping with the stress of caring for their terminally ill family members. This study explored the effectiveness of the implementation of Community/Home based care services by focusing on three sites at Bushbuckridge i.e. Cunningmore, Maviljan and Hluvukani. Findings revealed that family members were satisfied to have community caregivers entering their homes to provide care and support to their AIDS ill family members. Significant barriers were highlighted by families and community caregivers that hinder effective implementation of the programme, for instance, cultural sensitivity. The study proffered recommendations on how to deal with these issues. / SOCIAL WORK / MA(SS) (SOCIAL WORK)

This study compared the immunogenicity of inactivated SARS-CoV-2 vaccines between people living with HIV (PLWH) and HIV-negative individuals. We recruited 120 PLWH and 53 HIV-negative individuals aged 18-59 years who had received an inactivated SARS-CoV-2 vaccine in two Chinese cities between April and June 2021. Blood samples were tested for immunogenicity of the inactivated SARS-CoV-2 vaccines. The prevalence and severity of adverse events associated with SARS-CoV-2 vaccines were similar between PLWH and HIV-negative individuals. The seropositivity of neutralizing activity against authentic SARS-CoV-2, of the total amount of antibody (total antibody) and of S-IgG were 71.3%, 81.9%, and 92.6%, respectively, among fully vaccinated PLWH. Among all participants, PLWH had lower neutralizing activity, total antibody, S-IgG, and T-cell-specific immune response levels, compared to HIV-negative individuals, after controlling for types of vaccine, time interval between first and second dose, time after receiving the second dose, and sociodemographic factors. PLWH with a longer interval since HIV diagnosis, who received their second dose 15-28 days prior to study commencement, and who had an interval of ≥21 days between first and second dose had higher neutralizing activity levels. The immunogenicity of the inactivated SARS-CoV-2 vaccines was lower among PLWH as compared to HIV-negative individuals. Vaccination guideline specific for PLWH should be developed.